“It’s unfortunate that the Trump administration and Congress have chosen to create so much uncertainty about continuing that legally mandated payments,” said Mark Hall, a law professor at Wake Forest University who is a national expert on health care. “That uncertainty puts insurers, like Blue Cross, in a real bind: either they set their prices for next year based on the assumption that the payments will continue, but risk having to either cancel coverage or impose substantial mid-year increases. Or, they go ahead and price their products assuming these payments cease, which results in a rate increase that is almost three times what it would otherwise be.”

Francie Scott, interim director of the Office of Career & Professional Development at Wake Forest University School of Law, said many of the Winston-Salem school’s graduates hoping to stay in North Carolina are most interested in Charlotte, Raleigh and Wilmington.